Melanoma: A Patient’s Guide
What About My Psychological Well-Being?

Reaction to the diagnosis of melanoma, as with other types of cancers is complex. You and your family members may experience shock, anxiety, preoccupation or fear. These are normal reactions, and these feelings usually subside over time. However, they may not go away completely.

After a diagnosis of melanoma, treatment is initiated. It can be demanding for you and those involved in your care. Treatment for Stages 1, 2 and 3 melanoma usually involves surgery. Depending upon the size and location of the lesion, removal of the tumor can result in an unsightly appearance. Knowing in advance the expected size and depth of the scar and discussing how this will affect you emotionally, can help you to cope.

Treatment of Stage 4 melanoma may involve surgery and always involves some combination of chemotherapy and biologic therapy. Side effects such as loss of appetite and fatigue will require you to make adjustments to your daily routine. Being prepared for these changes and discussing how they will affect you both mentally and physically can help you manage your social and work schedules.

During and after treatment, it is important that you follow your physician's recommendations. Depending upon the stage of the cancer and the treatment, these will include behavioral changes such as limiting sun exposure and using sunscreen, as well as the continued need to examine your body for changes in the appearance of moles. You will also need to schedule follow-up visits with your physician. Some people delay seeking treatment and are lax in keeping medical appointments. If there is a remission and there are no symptoms, there is often uncertainty about the possibility of a recurrence. This uncertainty can cause people to be fearful or possibly minimize the importance of follow-up care. Anxious feelings or a failure to recognize the onset of new symptoms can lead to delay in seeking treatment or failure to comply with a physician's recommendations.

Some people have trouble performing the skin self-exam. For example, it is often easier to notice changes in moles on the arms and chest as opposed to the back. If you are unclear about how to perform the skin self-exam or have other questions about your care, be sure to ask your physician.

Some of the adjustments you will need to make require little effort, whereas others may seem overwhelming. Support and encouragement from family, friends and your health-care team will help minimize the difficulties associated with these adjustments. Support and encouragement are helpful at any time during the course of cancer diagnosis and treatment, but sometimes this is not enough. If you experience any of the following problems, you may benefit from additional counseling:

• persistent feelings of anxiety, depression or irritability
• feelings of hopelessness
• loss of interest in things you used to enjoy
• problems communicating with family, friends or the health-care team
• difficulty keeping scheduled appointments or following through with treatment recommendations.

Most hospitals and clinics have mental health professionals (social workers, psychologists, psychiatrists) who are knowledgeable about psychological issues related to melanoma. Ask your physician about mental health services at your clinic or hospital.

Characteristics of Abnormal Moles

Melanoma - A Guide For Patients

Cancer Care Information